Spend down vs. Liability

April 27, 2012 4:44 PM

From a policy perspective, what exactly is the difference between a Medicaid spend down vs. a liability? I work for a healthcare provider, so I know what they are and this question is not about the actual mechanics of paying either from a beneficiary perspective.

Spend downs are for those who make too much money to be eligibile. "Spending down" enough money on medical expenses (or paying the state Medicaid program directly), is used to reduce the income enough to qualify for Medicaid. Liabilities are also monthly payments that must be made by Medicaid beneficiaries, but for what, exactly? Is this just a different terminology for the same thing? (But some states have both, so that can't always be the case.)

Spend downs need to be paid to maintain Medicaid eligibility. Is this true with liabilities as well? Is this completely different state to state?

I'm most interested in Missouri, but any perspective will be appreciated.

posted by anonymous to Law & Government (1 answer total)

Each state is different, but here is the perspective from Michigan. This almost always deals with making an elderly person eligible for Medicaid funding for nursing home care.

"Spend-down" refers to a conscious and planned program to convert money and other assets that would be countable under the Medicaid program to those that would be non-countable, such as improvements to the home, purchase of a car, etc.

It sounds like "liabilities" refers to the normal and regular monthly expenses that any person would have: mortgage payments, insurance, utilities, loan payments, etc.
posted by yclipse at 5:35 PM on April 27, 2012